Patient engagement advice? Expect irrationality

It's not enough that people want to live healthier lives. Too many times, they just don't do what they're supposed to do. That reality is what makes patient engagement such a tough job for providers.

"If people would act rationally, they'd do things to improve their health – but people don't always act rationally," Douglas Hough said. "They will systematically not do the right thing."

Hough, an associate scientist and professor at Johns Hopkins Bloomberg School of Public Health, said clinicians must accept that their patient won't always act correctly, and instead create engagement programs that allow people to make their own decisions – with guidance, of course. In a sense, providers are promoting engagement by being less engaging.

Creating a wellness program that prompts people to opt out, as opposed to opting in is one example Hough pointed to because opt-out programs have a much higher engagement rate than those which require an initial opt-in.

While that might seem a bit lazy on the surface, it's actually a concept that's very familiar to those in the connected health space. To promote engagement, create pathways that don't affect the workflow. An opt-in button requires the user to do something different, or out of the ordinary, and therefore can just as easily be ignored. Conversely, if faced with an opt-out button, it's easier to just go with the flow.

To Hough, keeping patients engaged means interacting with them in targeted doses that lightly prod the patient forward. Bombarding them with reminders or information won't do the trick; nor will shaming them or blaming them. And when one method of engagement fades over time, find a new way to stay in touch or motivate them.

"People have got enough things to worry about," he said, and health and wellness won't be up there with the monthly bills, work pressures, home and family issues and perhaps even the local sports team. If they can just live healthier lives without being forced to do something radically different or reminded about it every day, it's all good.

It's a delicate path to tread, Hough says, and one that providers have to think about and use technology to enhance. For example, set up an online scheduling system that makes it easy for patients to make appointments, or employ e-prescribing so that their prescriptions are automatically refilled when necessary. And use a patient portal so that they can get information and ask questions on their time, not on the doctor's schedule.

And remember: If faced with a choice between taking a walk and having an extra piece of fried chicken, most people will opt for the chicken. The trick lies in finding a way to make that walk more appealing.